Long-Term Care

  • Robert L. Kane
  • Rosalie A. Kane


As with many social programs, long-term care (LTC) was not planned; most countries drifted into programmatic responses to an aging society. It is now necessary to rationalize what has evolved in bits and pieces. LTC poses a special problem because it covers so many aspects of life. It is essentially care in response to chronic dependency. It crosses many boundaries: physical and mental health care, health and social care, social services and housing, formal services, and family care.


Nursing Home Home Care Acute Care Informal Care Nursing Home Resident 
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  1. 1.
    Kane RA, Kane RL. Long-Term Care: Principles, Programs, and Policies. New York: Springer; 1987.Google Scholar
  2. 2.
    Weissert WG. Seven reasons why it is so difficult to make community-based long-term care cost-effective. Health Serv Res. 1985; 20: 423–434.PubMedGoogle Scholar
  3. 3.
    Kane RA. The noblest experiment of them all: learning from the national channeling evaluation. Health Serv Res. 1988; 23 (1): 189–198.PubMedGoogle Scholar
  4. 4.
    Weissert WG, Wan TTH, Livieratos BB. Effects and Costs of Day Care and Homemaker Services for the Chronically III: A Randomized Experiment. (DHEW Publication No. (PHS) 79–3258): Office of Health Research, Statistics, and Technology, National Center for Health Services Research, Department of Health, Education, and Welfare, Hyattsville, MD: National Center for Health Services Research; 1980.Google Scholar
  5. 5.
    GAO. Entering a Nursing Home—Costly Implications for Medicaid and the Elderly (PAD-80–12). Washington, DC: United States General Accounting Office; 1979.Google Scholar
  6. 6.
    Kemper P. Evaluation of the National Channeling Demonstration: overview of the findings. Health Serv Res. 1988; 23 (1): 161–174.PubMedGoogle Scholar
  7. 7.
    Carcagno GJ, Kemper P. The evaluation of the national long term care demonstration: an overview of the channeling demonstration and its evaluation. Health Serv Res. 1988; 23(l): l-22.Google Scholar
  8. 8.
    The Pepper Commission. A Call for Action: The Pepper Commission U.S. Bipartisan Commission on Comprehensive Health Care (Final Report): Washington, DC: U.S. Government Printing Office; 1990.Google Scholar
  9. 9.
    General Accounting Office. Long-term care: Diverse, growing population includes millions of Americans of all ages (GAO/HEHS-95–26): Washington, DC: US General Accounting Office; 1994.Google Scholar
  10. 10.
    Vladeck BC, Miller NA, Clauser SB. The changing face of long-term care. Health Care Financing Review. 1993; 14 (4): 5–23.PubMedGoogle Scholar
  11. 11.
    Kane RA, Wilson KB. Assisted Living in the United States: A New Paradigm for Residential Care for Frail Older Persons? Washington, DC: American Association of Retired Persons; 1993.Google Scholar
  12. 12.
    WHO. International Classification of Impairments, Disabilities, and Handicaps: A Manual of Classification Relating to the Consequences of Disease. Geneva: World Health Organization; 1980.Google Scholar
  13. 13.
    Kane RA, Kane RL. Assessing the Elderly: A Practical Guide to Measurement. Lexington, MA: DC Heath; 1981.Google Scholar
  14. 14.
    McDowell I, Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires. New York: Oxford University Press; 1987.Google Scholar
  15. 15.
    Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffee MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963; 185: 914–919.PubMedCrossRefGoogle Scholar
  16. 16.
    Lawton MP, Moss M, Fulcomer M, Kleban MH. A research and service oriented multilevel assessment instrument. J Gerontol. 1982; 37 (l): 91–99.PubMedCrossRefGoogle Scholar
  17. 17.
    Kemper P, Murtaugh CM. Lifetime use of nursing home care. N Engl J Med. 1991; 324: 595–600.PubMedCrossRefGoogle Scholar
  18. 18.
    Kane RL, Kane RA. Transitions in long-term care. In: Ory MG, Bond K, eds. Aging and Health Care: Social Science and Policy Perspectives. London: Routledge; 1989.Google Scholar
  19. 19.
    Isaacs B, Livingstone M, Neville Y. Survival of the Unfittest. London: Routledge and K. Paul; 1972.Google Scholar
  20. 20.
    Manton KG, Corder LS, Stallard E. Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from the 1982, 1984, and 1989 national long term care survey. J Gerontol Soc Sci. 1993; 48 (4): S153 - S166.CrossRefGoogle Scholar
  21. 21.
    DesHarnais S, Cheney J, Fleming S. Trends and regional variations in hospital utilization and quality during the first two years of the prospective payment system. Inquiry. 1988; 25: 374–382.PubMedGoogle Scholar
  22. 22.
    Guterman S, Eggers P, Riley G, Greene T, Terrell S. The first three years of Medicare prospective payment: an overview. Health Care Financ Rev. 1988; 9 (3): 67–82.PubMedGoogle Scholar
  23. 23.
    Kane RL, Kane RA. Posthospital care: a mystery and an opportunity. In: Vladeck BC, Alfano GJ, eds. Medicare and Extended Care: Issues, Problems, and Prospects. Owings Mills, MD: Rynd Communications; 1987.Google Scholar
  24. 24.
    Prospective Payment Assessment Commission. Medicare and the American Health Care System (Report to Congress). 1993.Google Scholar
  25. 25.
    Vladeck BG. Unloving Care: The Nursing Home Tragedy. New York: Basic Books; 1980.Google Scholar
  26. 26.
    Friedlob A. The Use of Physical Restraints in Nursing Homes and the Allocation of Nursing Resources. University of Minnesota, HSRA; 1993.Google Scholar
  27. 27.
    Mendelson MA. Tender Loving Greed. New York: Knopf; 1974.Google Scholar
  28. 28.
    Moss FE, Halamandaris VJ. Too Old, Too Sick, Too Bad: Nursing Homes in America. Germantown, MD: Aspen Systems; 1977.Google Scholar
  29. 29.
    Kane RL, Bell R, Riegler S, Wilson A, Kane RA. Assessing the outcomes of nursing home patients. J Gerontol. 1983; 38: 385–393.PubMedCrossRefGoogle Scholar
  30. 30.
    Kane RL, Bell RM, Riegler SZ, Wilson A, Keeler E. Predicting the outcomes of nursing-home patients. Gerontologist. 1983; 23 (2): 200–206.PubMedCrossRefGoogle Scholar
  31. 31.
    Garrard J, Kane RL, Radosevich DM, et al. Impact of geriatric nurse practitioners on nursing-home residents’ functional status, satisfaction, and discharge outcomes. Med Care. 1990; 28 (3): 271–283.PubMedCrossRefGoogle Scholar
  32. 32.
    Kane RL, Bell RM, Riegler SZ. Value preferences for nursing-home outcomes. Gerontologist. 1986; 26: 303–308.PubMedCrossRefGoogle Scholar
  33. 33.
    Katz K, Branch LG, Branson MH, Papsidero JA, Beck JC, Greer DS. Active life expectancy. N Engl J Med. 1983; 309: 1218–1224.PubMedCrossRefGoogle Scholar
  34. 34.
    Rogers A, Rogers RG, Branch LG. A multistage analysis of active life expectancy. Public Health Rep. 1989; 104: 222–226.PubMedGoogle Scholar
  35. 35.
    Manton KG. A longitudinal study of functional change and mortality in the United States. J Gerontol. 1988; 43 (5): S153–161.PubMedCrossRefGoogle Scholar
  36. 36.
    Boaz RF. Improved versus deteriorated physical functioning among long-term disabled elderly. Med Care. 1994; 32 (6): 588–602.PubMedCrossRefGoogle Scholar
  37. 37.
    Siu AL, Ouslander JG, Osterweil D, Reuben DB, Hays RD. Change in self-reported functioning in older persons entering a residential care facility. J Clin Epidemiol. 1993; 46 (10): 1093–1101.PubMedCrossRefGoogle Scholar
  38. 38.
    Boult C, Boult L, Murphy C, Ebbitt B, Luptak M, Kane RL. A controlled trial of outpatient geriatric evaluation and management. J Am Geriatr Soc. 1994; 42: 465–470.PubMedGoogle Scholar
  39. 39.
    Larson EB. Exercise, functional decline, and frailty. J Am Geriatr Soc. 1991; 39 (6): 635–636.PubMedGoogle Scholar
  40. 40.
    Tinetti M, Baker D, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994; 331 (13): 821–827.PubMedCrossRefGoogle Scholar
  41. 41.
    Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994; 330 (25): 1769–1775.PubMedCrossRefGoogle Scholar
  42. 42.
    Kosecoff J, Kahn KL, Rogers WH, et al. Prospective payment system and impairment at discharge. The “quicker-and-sicker” story revisited. JAMA. 1990; 264 (15): 1980–1983.PubMedCrossRefGoogle Scholar
  43. 43.
    Malone JK, Chase D, Bayard JL. Caring for nursing home residents. J Health Care Benefits. 1993; January/February: 51–54.Google Scholar
  44. 44.
    Polich CL, Bayard J, Jacobson RA, Parker M. A nurse-run business to improve health care for nursing home residents. Nurs Econ. 1990; 8 (2): 96–101.PubMedGoogle Scholar
  45. 45.
    Harrington C, Lynch M, Newcomer RJ. Medical services in social health maintenance organizations. Gerontologist. 1993; 33 (6): 790–800.PubMedCrossRefGoogle Scholar
  46. 46.
    Harrington C, Newcomer RJ, Moore TG. Factors that contribute to Medicare HMO risk contract success. Inquiry. 1988; 25: 251–262.PubMedGoogle Scholar
  47. 47.
    Harrington C, Newcomer RJ, Preston S. A comparison of S/HMO disenrollees and continuing members. Inquiry. 1993; 30 (4): 429–440.PubMedGoogle Scholar
  48. 48.
    Manton KG, Newcomer R, Vertrees JC, Lowrimore GR, Harrington C. A method for adjusting capitation payments to managed care plans using multivariate patterns of health and functioning: the experience of Social/health maintenance organizations. Med Care. 1994; 32 (3): 277–297.PubMedCrossRefGoogle Scholar
  49. 49.
    Newcomer R, Harrington C, Friedlob A. Awareness and enrollment in the Social/HMO. Gerontologist. 1990; 30 (1): 86–93.PubMedCrossRefGoogle Scholar
  50. 50.
    Newcomer R, Manton K, Harrington C, Yordi C, Vertrees J. Case mix controlled service use and expenditures in the social/health maintenance organization demonstration./Gerontol Med Sci. 1995; 50A (1): M35 - M44.Google Scholar
  51. 51.
    Newcomer RJ, Harrington C, Friedlob A. Social health maintenance organizations: assessing their initial experience. Health Serv Res. 1990; 25 (3): 425–454.PubMedGoogle Scholar
  52. 52.
    Leutz W, Greenlick MR, Ripley J, Ervin S, Feldman E. Medical services in Social HMOs: a reply to Harrington et al. Gerontologist. 1995; 35 (l): 6–8.PubMedCrossRefGoogle Scholar
  53. 53.
    Kane RL, Illston LH, Miller NA. Qualitative analysis of the Program of All-inclusive Care for the Elderly (PACE). Gerontologist. 1992; 32: 771–780.PubMedCrossRefGoogle Scholar
  54. 54.
    Prohaska T, Mermelstein R, Miller B, Jack S. Functional status and living arrangements. In: Van Nostrand JF, Furner SE, Suzman R, eds. Health Data on Older Americans: United States, 1992. Vital and Health Statistics. Hyattsville MD: National Center for Health Statistics; 1993: 3(27).Google Scholar
  55. 55.
    Kovar MG. Aging in the eighties, age 65 and over and living alone, contacts with family, friends, and neighbors. Preliminary data from the Supplement on Aging to the National Health Interview Survey: US, January-June 1984. Advance data from Vital and Health Statistics, No. 116. DHHS Pub. No. (PHS) 86–1250. Hyattsville, MD: Public Health Service; 1986.Google Scholar
  56. 56.
    Hing E. Use of nursing homes by the elderly: preliminary data from the 1985 National Nursing Home Survey, Advance data from Vital and Health Statistics, No. 135. DHHS Pub. No. (PHS) 87–1250. Hyattsville, MD: Public Health Service; 1987.Google Scholar
  57. Havlik RJ, Liu MG, Kovar MG, et al., eds. Health statistics on older persons, US, 1986. Vital and Health Statistics, Series 3, No. 25. DHHS Pub. No. (PHS) 87–1409. Hyattsville, MD: Public Health Service; 1987.Google Scholar
  58. 58.
    Sekscenski ES. Discharges from nursing homes: preliminary data from the 1985 National Nursing Home Survey, Advance data from Vital and Health Statistics, No. 142. DHHS Pub. No. (PHS) 87–1250. Hyattsville, MD: Public Health Service; 1987.Google Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Robert L. Kane
  • Rosalie A. Kane

There are no affiliations available

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